CMS Makes Critical Decision to Expand Medicare Telehealth Coverage for Audiology and Speech-Language Pathology Services

The Centers for Medicare & Medicaid Services (CMS) has added 24 Current Procedural Terminology (CPT) codes for audiology and speech-language pathology to the list of temporarily authorized Medicare telehealth services for use during the COVID-19 pandemic. The updated list, issued March 30, substantially expands the number of telehealth services audiologists and speech-language pathologists (SLPs) may now bill directly to Medicare—including swallowing, cognitive, speech-generating device, and hearing services—through the end of the federally declared public health emergency (PHE). The PHE is expected to last through at least the end of 2021 [PDF]. During this time, covered services must be billed to Medicare and audiologists and SLPs cannot bill patients directly. If you provided a telehealth service in January, February, or March 2021 and now intend to bill Medicare for this service, you will need to reimburse the patient. Medicare will process the claim and inform the beneficiary of their copayment obligation.

Since Congress granted CMS waiver authority last year to expand Medicare coverage of telehealth services, ASHA has persistently advocated for coverage of additional services to ensure patient access to medically necessary care and prevent transmission of COVID-19.

ASHA will continue advocating for permanent coverage of telehealth services under Medicare. Please contact your member of Congress and ask them to permanently authorize telehealth services for audiologists and SLPs by cosponsoring H.R. 2168.

Additions to the Medicare Authorized Telehealth Services List

Following are the additional CPT codes now included on the temporarily authorized Medicare telehealth services for use during the COVID-19 pandemic. More details about Medicare reimbursement for telehealth services is available on ASHA’s website.

Audiology Services

• 92550, Tympanometry and reflex threshold measurements
• 92552, Pure tone audiometry (threshold); air only
• 92553, Pure tone audiometry (threshold); air and bone
• 92555, Speech audiometry threshold
• 92556, Speech audiometry threshold; with speech recognition
• 92557, Comprehensive audiometry threshold evaluation and speech recognition
• 92563, Tone decay test
• 92565, Stenger test, pure tone
• 92567, Tympanometry (impedance testing)
• 92568, Acoustic reflex testing, threshold
• 92570, Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing
• 92587, Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report
• 92625, Assessment of tinnitus (includes pitch, loudness matching, and masking)
• 92626, Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); first hour
• 92627, Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); each additional 15 minutes

Speech-Language Pathology Services

• 92526, Treatment of swallowing dysfunction and/or oral function for feeding
• 92607, Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour
• 92608, Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes
• 92609, Therapeutic services for the use of speech-generating device, including programming and modification
• 92610, Evaluation of oral and pharyngeal swallowing function
• 96105, Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by Boston Diagnostic Aphasia Examination) with interpretation and report, per hour
• 96125, Standardized cognitive performance testing (eg, Ross Information Processing Assessment) per hour of a qualified health care professional's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report
• 97129, Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencing tasks), direct (one-on-one) patient contact; initial 15 minutes
• 97130, Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencing tasks), direct (one-on-one) patient contact; each additional 15 minutes (List separately in addition to code for primary procedure)

Questions?

ASHA’s website provides extensive information on providing Medicare telehealth services during the COVID-19 pandemic. Contact reimbursement@asha.org with any questions about coding and coverage of Medicare telehealth services.